April 19, 2013

Journalists’ Roundtable

Ted Simons: Good evening and welcome to "Arizona Horizon’s" Journalists Roundtable. I’m Ted Simons. Joining me tonight are Mary Jo Pitzl of "The Arizona Republic," Howard Fischer of Capitol Media Services, and Jim Small from "The Arizona Capitol Times." Budget negotiations and medicaid expansion talks continue at the state capitol. At least we would like to think they continue at the state capitol. What's going on?

Mary Jo Pitzl: Oh, they're continuing. It's just a question of where and at what level and the best we can tell, most of this discussion is still happening at the staff level, especially on the budget. With Medicaid I think a lot of that discussion is happening within the house and the Senate chambers as they try to figure out what their positions are going to be on that.

Ted Simons: Things moving forward? Are things happening or is it just kind of, you know,...

Mary Jo Pitzl: We were talking in the press room, it's a bit like a plane that took off and it's just circling and circling and circling.

Howard Fischer: And the problem becomes is that lining up the Republican votes? And you've got folks peeling off on all sides. You know, we understand why the conservatives don't like it, the federal deficit and quote Obamacare, but then you've got people like Michelle Reagan who say this is opposed by Scottsdale healthcare, they are the largest employer in my district so she said I'm not signing onto anything that they oppose so building that group of Republicans to go along the democrats remains difficult.

Ted Simons: Are things peeling off more than they did originally? What kind of progress or lack thereof?

Jim Small: It seems in the past several weeks, maybe the past month, the momentum has seemingly been with the critics. You've had -- and I think a lot of the people who peeled off have essentially been because of some of the social conservative issues. There's an issue that was raised by the center for Arizona policy that well, this money could give basically help subsidize abortions. Technically you can't spend the money on abortions. Groups like planned parenthood do take a small amount of Medicaid money and the argument is by them getting that money, it keeps the lights on, which in turn allows them to perform services that they don't like and so that has peeled off several Republicans, especially in the house. There's a challenge and an effort to try to find a way to put some language somewhere into state law that would make it clear that this isn't allowed but at the same time, not repeat what's already been struck down by a federal court.

Howard Fischer: And that's the key. This same language was put into a Medicaid bill last year, said that if you perform abortions, you are disqualified from any Medicaid funding and the federal judge, Neil wake, no flaming liberal, said no, that's not what federal law says. And so this idea that well maybe we should audit planned parenthood's books, to the extent you shove that kind of stuff in there, there go your democrats.

Ted Simons: Regardless of whether or not it's legal, what does it do as far as the dynamics of the vote?

Mary Jo Pitzl: It gives in a way easy cover for Republicans who are on the fence to say I can't vote for this, although it does beg the question if this would be a problem, then you should just not fund the whole access program in the state because this is just expanding what's already there and so but nobody's -- except for Andy Biggs is voting to introducing bills to do away with access, he has to be consistent. So it just helps to muddy the waters because it's also how you were saying, it has given something that perhaps they could negotiate around to try to bring people back on board if you can tamp down the concerns that Medicaid expansion would fuel abortions.

Ted Simons: I've asked this question to numerous folks, let me ask it to you guys. Let's say it doesn't pass. There is no Medicaid expansion, the deal is off. What are the state's options?

Howard Fischer: Well, there aren't a lot. A lot of it then becomes, you go back to the center for Medicaid studies and say we have a waiver that allows us to use federal funds for childless adults. That disappears at the end of this year, because the assumption was we're going to have this expanded program. Now, you go back and say look, we've tried but can we at least get the money for the childless adults? What the Obama administration will say, I don't know. On the one hand, they're not suggesting that now because they want to push the 133% of the federal poverty level. Otherwise, we're back to where we were, people get bounced off at the end of the year, that childless adults, the whatever's left of the rest of the program happens and the burden falls on the state. The fact is that this comes back to where you started, the budget. The budget that the governor sent is built on the fact if they can get $240 million from the hospitals that not only pays the state's share of the expansion but provides $100 million to back the other cause. Without that money, now we've got another budget problem.

Mary Jo Pitzl: But that is something that president Biggs said they're working on options that they could present to the governor on what they would do without doing Medicaid expansion. And, you know, at the end of the day, it comes down to taking money out of the general fund and is there a way to do that? If you keep the freeze on on the people that are eligible for the access program, over time that number's going to get smaller and smaller and, you know, eventually go to zero.

Jim Small: But that also assumes that the federal government allows us to keep the freeze on. The favor, when that expires, that gives us the 2-1 matching money for this population but, you know, the federal government did allow us to put that freeze into place but whether they allow Arizona to keep that freeze in place long-term or say you've got to open this program back up and those 150,000 people, you've got to pay for them out of the state's general fund, that's going to be an issue.

Howard Fischer: I think what happens if the Medicaid expansion goes down, and the federal government eventually says in October no we're not going to do this, we're back here in special session around Thanksgiving with the governor saying okay look kids, we know that the options where are, one more shot at it.

Ted Simons: Is that why the governor's office put out some new Medicaid figures? It sounds like this was a way to poke a little bit and say, by the way.

Mary Jo Pitzl: Oh yes. It's a way to sort of stir the pot. Very interesting, the numbers that came from the governor's office shows a higher cost to the state if you don't do expansions. It's vastly higher than what the legislative office is putting out in those numbers. Lots of space between those numbers.

Ted Simons: Speaking of medicine and such, the Senate now seems to have revived its medical pricing bill. What happened to the bill in the first place? Why did it need to be revised?

Howard Fischer: The idea is very basic It says do you want to have your car fixed, you go into pep boys, the oil change is so much, transmission so much, the same sort of thing, I want to go in for an x-ray, I want to go in for a C.A.T. scan, it should be publicly available. The bill went out, not a lot of opposition, and, all of a sudden, the governor says wait a second, there are problems with it. It would apply to federal hospitals where it can't apply. It would prohibit hospitals from offering discounts and it might make it hard for us to do price investigations. I think there was a little bit of looking for an excuse given that the sponsor is not a big fan of Medicaid. So the sponsor said okay, I'll take out the federal hospitals, I'll take out the Indian health service, I'll make it clear that hospitals can offer discounts, okay. Governor now what?

Ted Simons: And so what will the governor likely do?

Jim Small: Well, we don't know. The bill got amended, tacked onto another bill, that bill hasn't come up for a final vote in the Senate. I think you can kind of draw some conclusions as to why that hasn't happened yet but if you looked at the past, two years ago, Republicans did the same thing with the governor, they sent a bill for private school scholarships, she vetoed it and they addressed her concerns, they lowered the cost of it, tacked it onto an IRS conformity bill, an annual exercise the legislature does and she vetoed it with a snarky little letter and don't think I didn't notice. Now you can go back to work and fix this bill.

Ted Simons: They changed things in the bill but the hospital association, healthcare providers, they still don't like it do they?

Mary Jo Pitzl: They don't. And so that might be -- if this bill actually does get back up to the governor again and I think there is an if on that, that might give you an idea of where the governor might come from.

Howard Fischer: Look, I think the hospital association is making way too much out of this. Do I realize there are multiple rates? Nobody pays the bill charges, nobody is paying the $14 for the aspirin or anything else. The insurance companies negotiate charges, even as an individual payer, you can negotiate discounts. Medicair doesn’t pay the rate. But you have a booked rate. It is there. What is the great problem of saying that our standard bill charge of which we can negotiate discounts is x number of dollars for an x-ray, x number of dollars for a C.A.T. scan? But for whatever reason, the hospitals, for all their talk about transparency and how transparency helps Medicaid expansion and everything else, not so much for us.

Ted Simons: It sounds like their concerns are that those standard prices aren't so standard even within a single hospital when it comes to charity donations, insurance payouts, when it comes to actually adjusting for a single patient, those prices, you can't say it's x because it's x all over the place.

Howard Fischer: But the fact is somewhere in their books, they have the standard charge. Somebody from blue cross comes in, here's the discount. Somebody from Medicaid, here's the discount, somebody from Medicaid comes in, here's the discount. There is a book charge there.

Ted Simons: But if a book charge doesn't make any sense. A consumer that's confused about medical pricing to begin with, that would make a difference.

Howard Fischer: You can at least have the starting point, at least the starting point, at least lets me ask the questions.

Mary Jo Pitzl: I think it's a way to start that conversation, then why isn't there a standard going rate for a -- emergencies are a different kettle of fish but for your standard colonoscopy.

Ted Simons: Well, we'll see where it goes. It's very interesting to see that it may not even get there and if it does, we may see a, yeah. A militia, if you're over the age of 45, you apparently can't volunteer for the state militia? What are we talking about here?

Howard Fischer: Understand that there's really two different terms here. There is a state militia which consists of the national guard, retired guard members and the quote/unquote unorganized militia. All of us, well actually, I'm too old for it --

Ted Simons: Maybe you're not Howie

Howard Fischer: All of us are any able-bodied person between 18 and 45 under current law is a member of that. Nobody has ever called out the unorganized militia, it's one of those constitutional provisions that says if we need it. But for some reason, carl seal felt the need to say, you know, this militia we've never called out, you should be able to join up voluntarily at 46 or in my case 62 because lord knows, my state needs me. The governor said oh, come on now.

Ted Simons: I don't know what confuses me most that you're or that your state needs you.

Howard Fischer: I think it's both.

Ted Simons: What's going on here? Is this just a way to get the word militia out there?

Mary Jo Pitzl: This militia's never been activated. The governor's not a fan of this. It's a way to pump a little more air into it and draw a little more attention back to this dormant issue.

Jim Small: That's putting it mildly I think. We've got the litany of daily floor speeches he's given opposing it, may or may not have something to do with it.

Ted Simons: Another reason perhaps. A gun buyback bill. Cities buy back those guns and melt them down, now the state says, no?

Jim Small: The idea is a couple of years ago there was a law that was passed that said law enforcement when they seize a weapon, a crime, someone commits an armed robbery and the cops take the gun and they're going to dispose of the weapon, instead of destroying it, they have to sell it as long as it's a weapon that can legally be sold. So if it's say just a handgun, they have to turn around and sell it. If it's a sawed off shotgun, they would have to dispose of it. There was a loophole where municipalities, non-law enforcement could conduct a buyback program, did it in Tucson, used city money to basically buy guns from people so they could destroy them and that got under the skin of lawmakers who supported the idea of not destroying weapons and so the result was this bill that basically outlaws that practice and says you cannot use taxpayer dollars to basically run a gun buyback program.

Howard Fischer: What's interesting is on the one hand it's one of those second amendment fights but on the other hand Rick Murphy said this isn't second amendment. If you come into possession of a valuable asset, why should you destroy it to make someone feel good? If it can be sold off for $200, why melt it down? The question then becomes what if it had been Jared Loughner's gun? Of course, part of the problem with the arguments about a valuable asset is so if we seize some marijuana instead of destroying it, we should sell it off to one of the dispensaries, I don't see rick Murphy supporting that one.

Jim Small: Marijuana's illegal, except for medical marijuana but marijuana is generally illegal in the state and firearms are not, that would be the obvious counter to that.

Ted Simons: What is the governor likely to do with this one? On the face of it, might say makes sense, second amendment but this is, once again, the state medaling into municipal operations.

Howard Fischer: I think 60-40 she signs it. The bill she vetoed had to do with bringing guns into county buildings and she's been a county is supervisor. If the counties don't want them there, they have to have an armed gun and metal detectors and that's an unfunded mandate. This is -- remember she signed the first bill about court destruction, the second bill which was supposedly aimed at the cities, this simply closes that loophole. I don't see any reason why she suddenly says surrendered weapons should be able to be melted down but any other seized weapon is not.

Ted Simons: Okay. The Senate also and was this a surprise regarding the recall overhaul? We've heard a lot about this. First of all, tell us about this bill and was it a surprise that the Senate said, no?

Mary Jo Pitzl: This was a bill that representative Steve smith got through the house quite easily and it takes the recall on a party line vote and it says we're going to have a primary and a general and so this bill comes over to the Senate and they have a big, long debate and then senator Yarborough says we need to amend this because we've got to keep this constitutional. We have to make sure that the recalled official participates in both the primary and the general, which sort of begs the question of why have a primarily if you've got to have him to the general which the intent of the recall is that the recall election is the general election. So it got sort of confusing. And senator Gallardo said we should put it on the ballot and let the voters decide. Big, long kind of floor debate, it passed on a voice vote. When it came up for the formal vote, seven Republicans peeled off and joined the democrats to defeat it. Nobody really said much of anything about why. But it's cumbersome, it adds more time and length to the recall process and it's confusing.

Howard Fischer: The other piece of it, look at the Republicans who peeled off. Remember this all started because of the Russell Pearce recall. The argument of Steve smith was that if Russell Pearce had a face-off against Jerry Lewis, Russell would have survived and any democrat who came up would have been defeated. The recall single election allowed the Republicans to unite with democrats and independents behind Jerry Lewis and defeat Russell, which is why they wanted the dual primary. Look at the people, Rich Crandall – Bob Worsely, who’s only in politics because he defeated Russel’s attempt.

Mary Jo Pitzl: In a regular election.

Howard Fischer: But people like Steve Pearce, this is not the great, you know, Russell Pearce fan club. The other piece of it is talk about a bridge too far. They made the bill so it would theoretically be retroactive to January 1st. Gee, what recall has been started since January 1st?

Ted Simons: So we've got Russell Pearce, we've got the Joe Arpaio nod and don shooter voting against -- why? So he can revive this thing later on?

Howard Fischer: There's a procedural thing and jim knows this, too. You have to be on the prevailing side to make a motion to reconsider, that motion will come on Monday. Even if they agree to the motion to allow reconsideration, you've got way too many votes to line up. Short of twisting somebody's arm, I don't know Jim, do you think anybody's going to suddenly vote for this?

Jim Small: There might be a couple more that they get but when you lose seven Republican votes, it's a tough hill to climb.

Ted Simons: Speaking of don, it sounds like Yuma P.D. is recommending charges?

Mary Jo Pitzl: Yes, yesterday they closed their investigation and sent over a recommendation to the city prosecutor that he be prosecuted on four charges, trespass, assault, disorderly conduct and disrupting or interfering with the educational institution. So this is now in the hands of the city prosecutor who's probably going to take up to a month to review this and can do -- can use prosecutorial discretion to decide if these should go forward or not or do their own investigation.

Ted Simons: This involves an incident, barged into his grandson's classroom and threatening actions, claimed his teenage son was being bullied. Again, Yuma police recommending, these are misdemeanor charges but recommending nonetheless so the ethics investigation begins when?

Howard Fischer: This has been interesting because in some previous incidents, we haven't waited for an arrest. I think there are a lot of lawmakers who want to see what shakes out, particularly after some people say they've rushed to judgment on other things. I think the other piece of it there's a difference between don schuder. He's a nice guy, he showed up one day with holsters with two bottles of tequila. And I think they're more willing to give him the benefit of the doubt than they were Scott Bundgaard.

Ted Simons: Is there going to be an ethics probe?

Jim Small: A couple of things filed. At some point the democrats are going to file a complaint against him. They don't to take it up right away, they can sit on it and wait and senator Yarborough, the chair of the ethics committee said he's not going to-- he has the ability to proactively go out and initiate an investigation but he's not going to. He's going to wait until a complaint is filed and the big difference between this one and the Bundgaard one and the Daniel Patterson one is no real violence in this incident. He barged into a school and was angry and perhaps verbally abusive, allegedly verbally abusive but there was no violence. We didn't get calls to 911-- saying there are two people fighting on the side of the road or cops weren't called because there was a domestic dispute, which is what we saw in those last two.

Ted Simons: So police recommending charges is a bar too high?

Howard Fischer: Well, it is an interesting question. Look we're talking about, you know, class one and class two misdemeanors. The maximum penalty is six months in jail and a fine. I'm not saying that you should have to be convicted of a crime to be unethical. You know, part of the other issue is sometimes, you get people, one of the issues with the Bundgaard case became the allegations he was saying you can't arrest me, I'm a lawmaker. And the use of that. Now Shooter has not, as far as everything we've seen, he has not said to anybody you can't arrest me I'm a lawmaker, and I think that becomes part of the issue.

Mary Jo Pitzl: I think and I agree with jim, I expect democrats will file -- will file a complaint. This is the problem of an in-house ethics committee. They're effectively policing themselves and the public looking at it from the outside says where's the accountability? It's much harder to enforce these rules on yourself. Perhaps it makes the case for having an independent ethics commission that's done in many other states, Arizona has kept it in-house.

Ted Simons: And the likelihood of that happening?

Mary Jo Pitzl: Would likely have to come from external forces.

Ted Simons: Okay. We can't have a journalists round table with you here and not discuss something about medical marijuana. What do you have for us this week?

Howard Fischer: This is an interesting issue. We know there's several lawsuits out there dealing with the question of whether this federal preemption of state marijuana laws. One of the interesting cases out of Yuma where the woman had a medical marijuana card, she was stopped by border patrol, they seized the marijuana, the border patrol turned it over to the sheriff's office, the sheriff's office figured out she's got a card but wouldn't give her back her drugs. The second one is this fight over the white mountain dispensary in Glendale and whether the county has to issue the paperwork necessary for zoning and the argument of the prosecutors, including the prosecuting attorneys' advisory council is the state can't do this, you can't regulate something that is contrary to federal law. Yet at the same time, the prosecutors have been lobbying for a bill to regulate the packaging of marijuana, the brownies, the lollipops, the sodas to make sure they don't look like candy and it occurred to the county attorney wait a second, aren't we sort of undermining our cases in court saying we can't regulate when we're pushing a bill to regulate? So basically, the marijuana packaging measure is dead. I think they're going to let the court cases play out and find out how far the state can go.

Howard Fischer: There was the other bills about the return of the marijuana. The supreme court is going to deal with this. They're going to have to decide what is the authority of the voters of Arizona to enact a medical marijuana scheme in light of it being a schedule one drug, which is federal government says there's no medical use for. At some point we're going to get some definitive laws.

Ted Simons: All right, and that is definitively the end of our show. Good to have you all here, thanks for joining us. Monday on "Arizona Horizon," should healthcare providers be required to post their prices for common medical procedures? We’ll hear both sides of the issue. And Phoenix mayor Greg Stanton joins us to discuss a variety of issues facing his city. That’s Monday evening,5:30 and 10 , on "Arizona Horizon." Tuesday, renowned ASU physicist Lawrence Krauss talks about newly discovered earth-like planets and other science news. Wednesday, it’s our weekly legislative update with "The Arizona Capitol Times." Thursday, APS responds to a poll that shows support for solar energy in Arizona. And Friday, it’s another edition of the Journalists Roundtable. And that is it for now. I am Ted Simons. Thank you so much for joining us. You have a great weekend.